JMRH Vol. 12 No. 1 (December 2025)

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Browsing JMRH Vol. 12 No. 1 (December 2025) by Subject "3D skeletal data"

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    Biological Reconstruction in Musculoskeletal Oncology: Have We Reached a Turning Point?
    (Chitkara University Publications, 2026-05-30) Ashish Gulia
    In the field of musculoskeletal oncology, there has been a shift in ideology from local management of tumours with amputations to limb salvage surgery. Musculoskeletal oncology entered a new age of limb salvage due to advances in the fields of chemotherapy and radiation oncology, as well as in alloys, metals, and composites (Shojaie et al., 2023; Andrade et al., 2016). However, limb salvage is indicated only when we can achieve R0 margins and ensure that the major neurovascular structures remain uninvolved or reconstructible; salvage at all costs is a fallacy. Extensive soft tissue loss or a limb rendered insensate and ischemic is a contraindication to limb salvage surgery, where amputation would be a better functional choice. The “void” left behind after the resection of the diseased bone was filled with a metallic prosthesis. This gave our patients almost immediate freedom of motion, a stark contrast to the older philosophy of amputation/disarticulation. However, this came at a cost; we are not gods to provide bountiful gifts that last forever. The bones we replaced with metal had an expiration date, as initial results were good but were associated with multiple complications. We were essentially placing a mechanical part into a biological system and hoping the two would coexist. Hence, we argue that we have reached a definitive turning point and are moving out of the “Age of Mechanics” and into the “Age of Biologics.” Can we consider one method as superior to the other?